Healthcare Provider Details

I. General information

NPI: 1992636757
Provider Name (Legal Business Name): CASIDEE JAI SEGO LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 KEISLER DR STE 104
CARY NC
27518-9307
US

IV. Provider business mailing address

531 KEISLER DR STE 104
CARY NC
27518-9307
US

V. Phone/Fax

Practice location:
  • Phone: 919-439-9323
  • Fax:
Mailing address:
  • Phone: 919-439-9323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number21116A
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: